Individual provider · Type 1 NPI
Mija Park, NP
Family Nurse Practitioner · Woodside, NY
NPI number
1396677407
Active
Practice location
4124 50th St Apt 6E
Woodside, NY 11377-4318
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | F359461 (NY) |
Family Nurse Practitioner: Definition to come...
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About NPI 1396677407
Mija Park, NP's National Provider Identifier is 1396677407, issued on Jun 2, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Woodside, NY. The record was last updated on Jun 2, 2026.